Warning: package 'ggplot2' was built under R version 4.3.2Final Project Presentation
This storyboard delivers the final project product by exhibiting the final project in pages.
Data Visualization Project
Data Visualization Project
Storytelling with Data
Introduction
This project is about visualization of the public spending on saving environment.
Purpose
This project is about visualization of the spending on prescription drugs and effect of regulations.
Background
More than 131 Million people (66% of adults) in the US use prescription drugs
Prescription drugs are vital to maintain/improve health
The rising cost of prescription drugs = overburdened public healthcare systems and individual family budgets across the country
Affordability & accessibility is vital
Research Question
How do changes in prescription drug policies and regulations impact the affordability and accessibility of prescriptions?
Research Hypothesis
Prescription drug policies and regulations have had a measurable impact on affordability and accessibility of prescriptions
Philosophy
More like Wickham’s approach (not Tufte’s simplicity)
Layered Approach - building visualizations through layers (adding scales and aesthetics)
Customization - Customize visualizations extensively, allowing for fine-tuned control over every aspect of a chart.
Interesting and eye-catching visualizations
Statins
The prices of various prescription have been on the rise in the past decades
These are some of the commonly used medications
Statins- used to lower cholesterol levels
- The highest between 2014 and 2018
Inhalers
Case Study: Diabetes Prescriptions
Rising Prices
- Over the past two decades pharmaceutical manufacturers have increased list prices on insulin each year
- Over 9 million Americans rely on insulin, and they have been raising red flags over soaring prices for years.
Trend
From January 2014 to April 2019
The average cash price per insulin unit rose 54%
Then, from January 2020 to July 2023, it dropped by 10.6%.
Diabetes Prescription Use Over time
High costs, High risks
A drop in diabetes medication use in 2018
The high cost of insulin forced many people to ration the medication
People in the U.S. either skip, delay or use less insulin than was needed in the year to save money
Rationing can have dire consequences.
Comparing with Other Countries: 2018
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Analysis
We found a possible explanation for the drop in diabetes prescription use in 2018.
According to the chart, in 2018, the average list price for one vial of insulin in the U.S. was $98.70
Up to 10 times more than other countries in the OECD.
Why is this important
People with Type 1 diabetes need, on average 1 to 3 vials of insulin per month.
Patients with Type 2 diabetes don’t always need to take insulin, but those who do can sometimes require more than people with Type 1 diabetes.
Insulin Regulation
Inflation Reduction Act (IRA)
It went into effect in January 2023
Patients who are covered under the Medicare Part D plan now have a $35 out-of-pocket monthly cap for their insulin.
Higher rebates, even exceeding 100% of a drug’s price, in cases when manufacturers have raised list prices sharply over time and have offered substantial rebates triggering large best price discounts.
Effect of IRA on Manufacturers
Under the IRA, manufacturers will face penalties in Medicare for raising list prices faster than inflation
Impact of Legislation: Consumers
# Plot states with graduated colors representing annual savings
choropleth <- (
ggplot(data = map,
aes(fill = `Average Annual Out-of-Pocket Savings Per Enrollee ($)`)) +
labs(fill = "Average Annual Out-of-Pocket \nSavings Per Enrollee ($)") +
theme(plot.title = element_text(hjust = 0.5),
panel.grid.major = element_blank(),
panel.grid.minor = element_blank(),
axis.title.x=element_blank(),
axis.text.x=element_blank(),
axis.ticks.x=element_blank(),
axis.title.y=element_blank(),
axis.text.y=element_blank(),
axis.ticks.y=element_blank()
) +
geom_sf() +
geom_sf_text(aes(label = `STATE_ABBR`), size = 3) +
coord_sf(xlim = c(-165, -70), ylim=c(21,62)) +
scale_fill_gradientn(colours = brewer.pal(5, "Greens"),
labels = c("$300", "$400","$500","$600","$700", "$800")
) +
ggtitle("Inflation Reduction Act: Major Savings for Americans Who Use Insulin") +
guides(fill = FALSE)
)Warning: The `<scale>` argument of `guides()` cannot be `FALSE`. Use "none" instead as
of ggplot2 3.3.4.ggplotly(choropleth, tooltip="Average Annual Out-of-Pocket Savings Per Enrollee ($)")Warning in st_point_on_surface.sfc(sf::st_zm(x)): st_point_on_surface may not
give correct results for longitude/latitude dataThe map shows the estimated out-of-pocket savings if IRA had been in effect in 2020, by state
- webscraped data from report
-total savings to beneficiaries - $734 million in Part D and $27 million in Part B
an average savings of approximately $500 for those Medicare beneficiaries.
The states with the most people with Medicare projected to benefit from the new IRA insulin cost savings:
Texas -114,000 beneficiaries
California -108,000
Florida -90,000
- Highest average annual out-of-pocket savings
North Dakota - $805
Iowa - $725
South Dakota - $725
Impact of Legislation: Corporations
[1] "LLY"Impact of regulation:
Facing pressure to curb diabetes-treatment costs, Eli Lilly & Co. announced on March 1 that it is slashing insulin prices
They immediately capped the out-of-pocket cost of all of its insulin at $35 a month.
The graph shows Eli Lilly & Co. stock prices from June 2022 to most recent data
From the graph reduction in insulin price has not affected the bottom line of Eli Lilly & Co.
Future impact
IRA only applies to those with Medicare
But, medicare is the largest single purchaser of prescription drugs in the US.
This might further deter drug makers from increasing prices each year while offering greater rebates to insurers.
Impact of Legislation: Corporations
[1] "NVO"Novo Nordisk and Sanofi are other dominant insulin manufacturers that announced they have drastically lowered list prices and out-of-pocket costs in March 2023.
Novo Nordisk stock prices have an upward trend
Impact of Insurance
Warning: Ignoring 5 observationsThe graph shows how affordability of prescription medication varies by:
insurance, coverage type, and income.
Affordability problems increase as income falls and are much higher among those without insurance coverage.
People with diabetes enrolled in high-deductible plans report greater affordability problems than those in conventional private insurance plans.
Affordability
The Affordable Care Act (ACA)
Prices increased rapidly between 2007 and 2017
But, coverage expansions reduced the share of those with diabetes in each income group who reported difficulty affording prescription drugs.
The greatest declines have been among people with incomes between 100 percent and 300 percent of the federal poverty level
Takeaways
Our analysis suggests that the most important factors affecting the affordability of insulin:
the availability of coverage
the form of that coverage
People with adequate coverage are often shielded from these price increases.
Medicaid expansion
people with diabetes who can enroll in Medicaid are protected from:
high out-of-pocket costs for prescription
high costs for other dimensions of their care